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.P °'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
_ FOR DEDUCTION FROM ASSESSED VALUATION � �
Slale Fartn 43709 (RB / 2-07)
S � Presmbed by DepaM1ment of Local GovemmeM Financa
INS7RUCTIONS: AP�(��1 U L�OOB
To be filed in person or by mar7 wifh the CountyAuditor d fhe couMy where fhe property is located.
Fding Dates: i) Real Property: During the 12 months before June 11 0/ the year the deduction is to be e8ective. /� d
2) Mobile Hanes assessed under IC 61.7-7: Behveen January 15 and March 2 0( fhe year the deduc6on is to b� A" ���"
See reverse side for additiorral inshuctions a� qualficafions. � �
GIBSON COUNTY AUDITOR
or mntrae buye�
If ro, whal is his I her ezad share oi
�e m recwd is d'rt(arenl ihan Ih
Name of mortgagee or cantrac� selle
on reyerse
Key number / legal tlescri n Reoortl num Pa� � I
-/a. �`°-io� -po3, �08 - c�a-8 D�
March 1, arrent y�r Alortga9e / ConUad indehted�ress unpai0 as of Alarrh i, Is Ihe appGpnl Ihe sole legal w equitade o.meR
curren� r� /�'/ (^ S n(� ❑ res -❑ No
Address of rtwrtgagee or mntratl seller (numbu a�M ffiee4 tity, stafe.
Name of essignee or oU�er ovr�r or holAer
Address of asvg�e (rwmbei aiM sLeeL a
Dces applican� own poperty in any oU�er
cwnty in Indana?
❑Yes ❑ No
DeduGion appmved in Ihe amaunt of:
20 20 �d
r
SignaWre of Camly Fwditor
If owned wi7h someone dher,�han spouse,
Is �he property in quasUrn:
❑ Real Property ❑ MWzle Home pC G7.1-7)
m� Dra�ver i\'O, ��- / 6
.........9.. .�
�ate.andLPcode) Cai(� 1\rO. .
....................
If yes, what cwnry? what Te on propeM
s ❑ No
2p � 20 � 20 _
Counry
20 _
Dale (mmlh, day, yea�
20
I/ We certify under Ihe ps�alty of pe�jury that fhe above and foregoing infortnatio� is We and coRect and that tlie applipnts was / were a resident of
Indiana and owner of �h forementi ed properry on March 1, 20
� e wners me) �a1e (month, day, yea�
address af apdicant (number and streel. cAy, sFate, a�q3(P oode)
Pl�wney a by
Adtlress of aullwr¢ed persan (num6er aM sfreel,
Date